Kwei Akuete, M.D., M.P.H., from Texas Children's Hospital in Houston, and colleagues surveyed physicians located at five food allergy centers geographically distributed across the United States in order to examine the epidemiology, symptoms, and treatment of clinical low-risk OFCs in the nonresearch setting. Survey data were obtained from 2008 to 2013.

The researchers found that in the 6,377 OFCs performed, the pooled estimate of anaphylaxis was 2 percent. The rate of allergic reactions remained consistent at around 14 percent (P = 0.40), while reaction rates ranged from 13 percent to 33 percent. Compared with females, males reacted 16 percent more frequently (P = 0.04). There was geographic variation, with peanut as the most challenged food in the Northeast, Midwest, and West and egg the most challenged in the South.

"As the largest national survey of allergic reactions of clinical open OFCs in a nonresearch setting in the United States, this study found that performing clinical nonresearch open low-risk OFCs results in few allergic reactions, with 86 percent of challenges resulting in no reactions and 98 percent without anaphylaxis," conclude the authors.